Frequency Of CRP Levels In Patients Presenting With Acute Coronary Syndrome

CRP Levels in Patients with Acute Coronary Syndrome


  • Kamran Aslam Department of Cardiology, Lady Reading Hospital, Peshawar, Pakistan
  • Erum Khan Karachi Medical and Dental College, Karachi, Pakistan
  • Zeeshan Malik University of Lahore, Lahore, Pakistan
  • Asfandiar Ali Department of Cardiology, Aga Khan University Hospital, Karachi, Pakistan
  • Aamir Nawaz khan Lady Reading Hospital, Peshawar, Pakistan
  • Fnu Fatima Jinnah Sindh Medical University, Karachi, Pakistan
  • Qamer Hyder Khan Jinnah Postgraduate Medical Centre, Karachi, Pakistan
  • Mohammad Hasan Jinnah Postgraduate Medical Centre, Karachi, Pakistan



CRP, Acute MI, ACS, Cardiac Care


Myocardial necrosis is thought to be the etiology of acute coronary syndrome (ACS) and elevated CRP levels in the first 12 hours after an intervention is linked to a higher risk of cardiovascular recurrence and death. Objectives: To evaluate if CRP has any predictive value in predicting cardiovascular outcomes in ACS patients. Methods: We conducted a cross-sectional study at Jinnah Post Graduate Medical Centre from Oct 2021 to March 2022.  117 patients of both gender aged between 40 to 80 years, presenting with chest pain were included in the study.  Data were analyzed on SPSS Version 25. Chi-square was used to compare the outcomes of both groups. The age and gender were stratified to control the effect modifiers. The p-value of <0.05 was considered significant. Results: There were a total of 117 patients enrolled in this study. Among them, there were 63 (53.85%) males, and 79 (67.52%) were above 60 years of age. There were 90(76.92%) patients who had a raised CRP level, and 78 (66.67%) had a duration of ACS > 12 hours. Differences between the duration of elevated CRP and non-elevated CRP were statistically significant (p-value = 0.013). Conclusions: CRP levels may be indicative of suspected acute coronary syndrome. Physicians can identify such patients and provide them with more intensive health care and cardiac management. Resources are scarce in the developing world. Having such tools that are more economical can help with the diagnosis and provide better care.


Murray CJ and Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. The Lancet. 1997 May; 349(9061): 1269-76. doi: 10.1016/S0140-6736(96)07493-4

Yayan J. Erythrocyte sedimentation rate as a marker for coronary heart disease. Vascular Health and Risk Management. 2012 Apr: 219-23. doi: 10.2147/VHRM.S29284

Sheikh A, Yahya S, Sheikh N, Sheikh A. C-reactive protein as a predictor of adverse outcome in patients with acute coronary syndrome. Heart views: The Official Journal of the Gulf Heart Association. 2012 Jan; 13(1): 7. doi: 10.4103/1995-705X.96660

Ojha N and Dhamoon AS. Myocardial infarction. InStatPearls 2021 Aug. StatPearls Publishing.

Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes. New England Journal of Medicine. 1992 Jan; 326(4): 242-50. doi: 10.1056/NEJM199201233260406

Kobiyama K and Ley K. Atherosclerosis: a chronic inflammatory disease with an autoimmune component. Circulation research. 2018 Oct; 123(10): 1118-20. doi: 10.1161/CIRCRESAHA.118.313816

Nishuty NL, Khandoker MM, Karmoker JR, Ferdous S, Shahriar M, Qusar MS, et al. Evaluation of serum interleukin-6 and C-reactive protein levels in drug-naïve major depressive disorder patients. Cureus. 2019 Jan; 11(1). doi: 10.7759/cureus.3868

Sproston NR and Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Frontiers in Immunology. 2018 Apr; 9: 754. doi: 10.3389/fimmu.2018.00754

Buerke M, Sheriff A, Garlichs CD. CRP apheresis in acute myocardial infarction and COVID-19. Medizinische Klinik, Intensivmedizin und Notfallmedizin. 2022 Mar; 117(3): 191-9. doi: 10.1007/s00063-022-00911-x

Zhang XY, Zhang G, Jiang Y, Liu D, Li MZ, Zhong Q, et al. The prognostic value of serum C‐reactive protein‐bound serum amyloid A in early‐stage lung cancer. Cancer Communications. 2015 Dec; 34(3): 1-15. doi: 10.1186/s40880-015-0039-1

Kamal (Komo) Gursahani M, MBA. Cardiac Markers. 2021 Jul. [Last cited: 30th Jul 2021]. Available at:

Li W, Luo X, Liu Z, Chen Y, Li Z. Prognostic value of C-reactive protein levels in patients with bone neoplasms: a meta-analysis. PloS One. 2018 Apr; 13(4): e0195769. doi: 10.1371/journal.pone.0195769

Yuksel Cavusoglu M, Bulent Gorenek M, Seref Alpsoy M, Ahmet Unalir M, Necmi Ata M, Timuralp B. Evaluation of C-reactive protein, fibrinogen and antithrombin-III as risk factors for coronary artery disease. Age (yr). 2001; 58: 10.

Chew DP, Bhatt DL, Robbins MA, Penn MS, Schneider JP, Lauer MS, et al. Incremental prognostic value of elevated baseline C-reactive protein among established markers of risk in percutaneous coronary intervention. Circulation. 2001 Aug; 104(9): 992-7. doi: 10.1161/hc3401.095074

Blake GJ and Ridker PM. C-reactive protein and other inflammatory risk markers in acute coronary syndromes. Journal of the American College of Cardiology. 2003 Feb; 41(4S): S37-S42. doi: 10.1016/S0735-1097(02)02953-4

Rifai N and Warnick GR. Quality specifications and the assessment of the biochemical risk of atherosclerosis. Clinica Chimica Acta. 2004 Aug; 346(1): 55-64. doi: 10.1016/j.cccn.2004.02.034

Rifai N and Ridker PM. Proposed cardiovascular risk assessment algorithm using high-sensitivity C-reactive protein and lipid screening. Clinical chemistry. 2001 Jan; 47(1): 28-30. doi: 10.1093/clinchem/47.1.28

Khera A, McGuire DK, Murphy SA, Stanek HG, Das SR, Vongpatanasin W, et al. Race and gender differences in C-reactive protein levels. Journal of the American College of Cardiology. 2005 Aug; 46(3): 464-9. doi: 10.1016/j.jacc.2005.04.051

Kavsak PA, MacRae AR, Newman AM, Lustig V, Palomaki GE, Ko DT, et al. Elevated C-reactive protein in acute coronary syndrome presentation is an independent predictor of long-term mortality and heart failure. Clinical Biochemistry. 2007 Mar; 40(5-6): 326-9. doi: 10.1016/j.clinbiochem.2006.10.025

Morrow DA, Rifai N, Antman EM, Weiner DL, McCabe CH, Cannon CP, et al. C-reactive protein is a potent predictor of mortality independently of and in combination with troponin T in acute coronary syndromes: a TIMI 11A substudy. Journal of the American College of Cardiology. 1998 Jun; 31(7): 1460-5. doi: 10.1016/S0735-1097(98)00136-3

Frenette PS. Locking a leukocyte integrin with statins. New England Journal of Medicine. 2001 Nov; 345(19): 1419-21. doi: 10.1056/NEJM200111083451911

Ridker PM, Rifai N, Clearfield M, Downs JR, Weis SE, Miles JS, et al. Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events. New England Journal of Medicine. 2001 Jun; 344(26): 1959-65. doi: 10.1056/NEJM200106283442601

Albert MA, Danielson E, Rifai N, Ridker PM, Investigators P, Investigators P. Effect of statin therapy on C-reactive protein levels: the pravastatin inflammation/CRP evaluation (PRINCE): a randomized trial and cohort study. Jama. 2001 Jul; 286(1): 64-70. doi: 10.1001/jama.286.1.64



DOI: 10.54393/pjhs.v4i03.582
Published: 2023-03-31

How to Cite

Aslam, K. ., Khan , E. ., Malik, Z. ., Ali, A. ., Nawaz khan , A. ., Fatima, F. ., Hyder Khan, Q. ., & Hasan, M. . (2023). Frequency Of CRP Levels In Patients Presenting With Acute Coronary Syndrome : CRP Levels in Patients with Acute Coronary Syndrome . Pakistan Journal of Health Sciences, 4(03), 78–82.



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